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    Comparison Of Intrathecal Plain Articaine And Levobupivacaine With Fentanyl For Caesarean Section
    (The Canadian Society for Clinical Investigation, 2016) Demircioğlu, Rüveyda İrem; Goz?demir, Muhammet; Usta, Burhanettin; Sert, Hüseyin; Karabayirli, Safinaz; Muslu, Bünyamin; Keskin, Esra Aktepe
    Purpose: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. Methods: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 ?g intrathecally. The onset and duration of sensory and motor block, first analgesic request, and hemodynamic parameters were recorded. Results: Onset times of maximum motor block were longer in Group L than Group A (P=0,001). Time to two-segment regression of sensory block were 70 min for Group A and 90 min group L (P=0.001). Times to complete regression of motor blockade were significantly longer in group L than group A (P =0,001). Conclusion: To have a faster onset and shorter duration of spinal anesthesia, we recommend the use of plain articaine for Caesarean section © 2021 Elsevier B.V., All rights reserved.
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    The effect of hypotermia on potassium concentration in blood cardioplegia during cardiopulmonary bypass surgery
    (Turkish Anaesthesiology and Intensive Care Society tsisa@logos.com.tr, 2014) Peker, Murat; Karabayirli, Safinaz; Özanbarci, Azra; Çolak, Necmettin; Demircioğlu, Rüveyda İrem; Muslu, Bünyamin
    Objective: Cardioplegia is quite important for myocardial protection during cardiopulmonary by-pass In order to benefit from cardioprotective effect of hypotermia cold- blood cardioplegia is commonly used. Hypotermia can alter potassium concentration. In this study we have investigated the effect of hypotermia on potassium concentration in blood cardioplegia. Material and Methods: We studied 70 patients who will undergo coronary artery bypass grafting with the aid of cardiopulmonary bypass. Potassium levels were measured from arterial blood samples of the patients before the cardiopulmonary bypass (CBP) operation. During CBP surgery, in order to achieve 16 mEq/L potassium levels, potassium was added to a 400 ml blood sample taken from cardiopulmonary pump to prepare blood cardioplegia. After addition of potassium, blood samples were deri altiwn to measure blood gases, potassium, sodium, calcium and lactate levels Blood cardioplegic solution was cooled at 4°C in an ice water container and measurements were repeated. Results: Potassium levels were detected as 16.8±0.7 mEq/L at 32°C and 16.3±0.7 mEq/L at 4°C in samples of blood cardioplegic solution (p=0.001). There was no difference bet ween analytical results of blood gases and other electrolytes. Conclusion: A decrease in potassium levels is observed after cooling blood cardioplegic solution at 4°C. However this decrease which occurs at 0.5 mEq/L concentrations may not be so important clinically. Whereas, during preparation of cardioplegic solution, estimated potassium levels were near the lower limits,m then cooling process might drop potassium levels below this lower limit. Therefore it may be helpful to keep the potassium level slightly above the target level. © 2014 Elsevier B.V., All rights reserved.